# GLENDALE REJUVENATION MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457011256
- **Authorized official:** JEFFREY FEINBERG (ADMINISTRATOR)
- **Authorized official phone:** (818) 430-6312

## Contact information

- **Practice address:** 1703 N AVALON BLVD, WILMINGTON, CA 90744-1432
- **Practice address phone:** (818) 518-5980
- **Mailing address:** 7230 MEDICAL CENTER DR STE 405, WEST HILLS, CA 91307-1940
- **Mailing address phone:** (818) 518-5980

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 12/21/2021
- **Last updated:** 12/21/2021